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Updated: Jun 2, 2026
Monitoring Dynamic Growth of Retinal Vessels in Oxygen-Induced Retinopathy Mouse Model
Published on: April 2, 2021
On the use of antiangiogenetic medications for retinopathy of prematurity
Anna-Lena Hård1, Ann Hellström
1Department of Ophthalmology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Insights
New treatments for retinopathy of prematurity (ROP) using anti-VEGF and propranolol may impact infant development. These therapies target abnormal blood vessel growth but could affect critical developmental periods in preterm infants.
Area of Science:
- Neonatal development
- Ophthalmology
- Developmental biology
Background:
- The third-trimester fetus undergoes rapid growth and maturation.
- Early development includes critical periods sensitive to environmental influences.
- Proliferative retinopathy of prematurity (ROP) is a blinding condition caused by uncontrolled retinal angiogenesis.
Purpose of the Study:
- To evaluate the potential impact of antiangiogenetic treatments for ROP on preterm infants.
- To raise concerns about the systemic effects of novel ROP therapies.
Main Methods:
- Review of current understanding of fetal development and ROP.
- Analysis of the roles of VEGF and the adrenergic system in infant development.
- Consideration of ongoing and planned studies on anti-VEGF and propranolol for ROP.
Main Results:
- Vascular Endothelial Growth Factor (VEGF) is crucial for normal angiogenesis in infants.
- The adrenergic system plays a role in multiple organ systems and sensory system plasticity.
- Current antiangiogenetic treatments for ROP may have unintended consequences.
Conclusions:
- Concerns exist regarding the safety and developmental impact of antiangiogenetic treatments for ROP.
- Further research is needed to understand the long-term effects of these therapies on preterm infants.
Unlabelled:
In contrast to the adult, the third-trimester foetus experiences one of the most intense periods of growth and maturation of its lifetime. Early development is characterized by the existence of critical periods when environmental factors effectively produce long-lasting changes. Proliferative retinopathy of prematurity (ROP) is a potentially blinding disease characterized by uncontrolled retinal angiogenesis. This pathologic angiogenesis is the target for two new treatment modalities for ROP, i.e. intravitreal anti-VEGF (bevacizumab) and systemic propranolol, which are being evaluated in ongoing or planned studies. VEGF is essential for normal angiogenesis in a growing infant, and the adrenergic system is important for many organ systems and, in addition, for plasticity of the visual and olfactory systems.
Conclusion:
This viewpoint raises concerns regarding the currently studied antiangiogenetic treatments for ROP and their possible general effects on the developing preterm infant.
